How to Code Acute Vestibular Syndrome in ICD-11: Complete Guide

Introduction

Acute vestibular syndrome (AVS) represents one of the most important diagnostic challenges in neurological and otolaryngological clinical practice. Characterized by sudden-onset, intense and continuous vertigo, this condition may last days or weeks and is frequently accompanied by nausea, vomiting, nystagmus and severe postural instability. AVS significantly affects patients' quality of life, preventing basic daily activities and, in severe cases, leading to temporary disability. Precise recognition of this syndrome is crucial not only for appropriate treatment, but also for rapidly identifying potentially serious causes, such as cerebrovascular accidents (CVAs) affecting the cerebellum or brainstem.

Correct coding of acute vestibular syndrome in ICD-11 plays a fundamental role in multiple aspects of healthcare delivery. From an epidemiological standpoint, it allows tracking of the incidence and prevalence of this condition, contributing to resource planning in emergency services and specialized units. From an administrative perspective, it ensures appropriate reimbursement by healthcare systems, considering that patients with AVS frequently require emergency care, brain imaging studies and, occasionally, hospital admission for intravenous hydration and symptom management. Precise documentation is also essential for clinical studies evaluating new therapeutic approaches and diagnostic protocols, especially those aimed at differentiating between benign peripheral causes and potentially fatal central causes.

The impact of appropriate coding extends to patient safety and quality of care. AVS presents itself as a spectrum of conditions ranging from relatively benign vestibular neuritis to cerebellar CVAs that may progress to neurological deterioration and death if not recognized early. Well-structured registry systems, grounded in precise coding, allow quality audits, identification of clinical presentation patterns and development of evidence-based protocols. Furthermore, correct classification facilitates communication among different medical specialties involved in the care of these patients, including neurologists, otolaryngologists, emergency physicians and physical therapists specialized in vestibular rehabilitation.

Correct ICD-11 Code

Code: AB30

Description: Acute vestibular syndrome

Chapter: 10 - Diseases of the ear or mastoid process

Official definition (ICD-11):

A clinical syndrome of acute onset, continuous vertigo, dizziness or instability lasting days to weeks and usually including features suggestive of acute and continuous dysfunction of the vestibular system (for example, vomiting, nystagmus, severe postural instability). There may also be symptoms or signs suggestive of cochlear or central nervous system dysfunction. Acute vestibular syndrome usually connotes a single and monophasic event, often caused by a single disorder, but may instead punctuate a course of recurrent and remitting or gradual progressive disease. Disorders that typically present with this syndrome include vestibular neuritis, acute labyrinthitis, traumatic vestibulopathy, demyelinating disease with vestibular involvement, and cerebrovascular accidents / strokes affecting central or peripheral vestibular structures.

Important: Code AB30 should be used when the patient presents with the acute syndromic presentation, regardless of the specific etiology not yet confirmed. Subcategories AB30.0 (Vestibular neuritis) and AB30.1 (Labyrinthitis) should be used when the specific etiology is established.

When to Use This Code

✅ Situation 1: Patient with acute rotatory vertigo and unidirectional spontaneous nystagmus

Criteria:

• Sudden onset of intense and continuous vertigo
• Unidirectional spontaneous nystagmus visible on physical examination
• Associated nausea and vomiting
• Gait instability with tendency to fall
• Absence of focal neurological signs
• Expected duration of days to weeks

Example: "A 45-year-old female patient presents to the emergency department reporting rotatory vertigo of sudden onset 8 hours ago, with intense sensation that the environment is spinning. She reports three episodes of vomiting and inability to stand without support. On examination, horizontal spontaneous nystagmus beating to the right is observed, without changes in strength or sensation. Head impulse test (HIT) positive to the left. No headache, diplopia, or dysarthria. Code AB30 applied, magnetic resonance imaging requested to exclude stroke, and symptomatic treatment initiated."

✅ Situation 2: Suspected case of vestibular neuritis awaiting confirmation

Criteria:

• Clinical presentation compatible with vestibular neuritis
• Complementary vestibular evaluation pending
• Need for coding for hospitalization or emergency care
• Absence of definitive etiological confirmation

Example: "A 58-year-old man with diabetes mellitus presents with continuous vertigo for 24 hours, persistent vomiting, and inability to ambulate. Denies recent head trauma or infection. Brief neurological examination without alterations beyond the vestibular component. Decision to admit for intravenous hydration and videonystagmography within the next 48 hours. Coded AB30 for hospitalization processing, with provision for specification to AB30.0 after diagnostic confirmation."

✅ Situation 3: Acute post-traumatic vestibular syndrome

Criteria:

• History of recent head or cervical trauma
• Onset of vertigo in the hours or days following trauma
• Persistent and disabling vestibular symptoms
• Imaging studies excluding major structural lesions

Example: "A 32-year-old patient victim of a motor vehicle accident 3 days ago, with mild cervical trauma without fracture. Developed intense vertigo 12 hours ago, with vomiting and nystagmus. Cranial computed tomography without acute changes. Cervical magnetic resonance imaging shows only soft tissue edema. Considering traumatic vestibulopathy, code AB30 is applied. Reevaluation with otoneurologist scheduled in 1 week to define need for vestibular rehabilitation."

✅ Situation 4: Initial differentiation of stroke versus peripheral cause

Criteria:

• Presentation with acute vestibular syndrome
• Need for urgent exclusion of cerebellar or brainstem stroke
• Application of diagnostic protocols (HINTS, ABCD²)
• Awaiting neuroimaging results

Example: "A 72-year-old woman with arterial hypertension and atrial fibrillation presents with sudden vertigo, vomiting, and gait ataxia for 2 hours. On examination, horizontal-torsional nystagmus, but presence of dysmetria on finger-to-nose test. HINTS protocol (Head Impulse, Nystagmus, Test of Skew) applied with result suggestive of central cause. Code AB30 applied temporarily while awaiting urgent cranial MRI. On-call neurologist contacted for joint evaluation."

✅ Situation 5: Acute labyrinthitis with associated auditory symptoms

Criteria:

• Acute vertigo accompanied by hearing loss or tinnitus
• Suggestion of simultaneous cochlear and vestibular involvement
• Presentation compatible with viral or bacterial labyrinthitis
• Awaiting audiometry and otolaryngological evaluation

Example: "A 50-year-old man reports intense rotatory vertigo starting 36 hours ago, accompanied by sudden hearing loss on the right and ipsilateral tinnitus. He reports upper respiratory viral infection the previous week. Otoscopic examination without signs of otitis media. Urgent audiometry reveals sensorineural hearing loss on the right. Coded AB30 with suspicion of viral labyrinthitis. Corticosteroid therapy initiated and follow-up scheduled for possible specification as AB30.1."

✅ Situation 6: Acute vestibular syndrome in young patient

Criteria:

• Young patient without cardiovascular risk factors
• Typical presentation of peripheral vestibular dysfunction
• Investigation for rare causes (demyelination, autoimmunity)
• Favorable evolution with symptomatic treatment

Example: "A 28-year-old patient, previously healthy, develops intense and continuous vertigo following an episode of viral respiratory infection. Presents with unidirectional spontaneous nystagmus, positive head impulse test, without focal neurological signs. Cranial MRI normal. Cerebrospinal fluid without alterations. Serology for herpes virus in progress. Code AB30 applied and early vestibular rehabilitation initiated. Good response to conservative treatment in 5 days of follow-up."

✅ Situation 7: Vestibular syndrome in the context of demyelinating disease

Criteria:

• Patient with previous diagnosis or suspicion of multiple sclerosis
• New episode of acute vertigo and nystagmus
• Possible demyelinating relapse with vestibular involvement
• Need for investigation with MRI and neurological evaluation

Example: "A 35-year-old woman with established diagnosis of multiple sclerosis presents with a new relapse characterized by continuous vertigo for 48 hours, vertical nystagmus, and gait ataxia. Magnetic resonance imaging shows new demyelinating lesion in the middle cerebellar peduncle. Coded AB30 as manifestation of the relapse. Pulse therapy with methylprednisolone initiated. Prediction of functional recovery in 2-3 weeks with intensive vestibular physiotherapy."

When NOT to Use This Code

❌ Situation 1: Brief episodic vertigo

If the patient presents with episodes of vertigo lasting seconds to minutes, triggered by changes in head position, without continuous symptoms → use code AB31 (Episodic vestibular syndrome) or AB31.0 (Benign paroxysmal positional vertigo)

Rationale: AVS is characterized by CONTINUOUS vertigo lasting days to weeks, not by brief recurrent episodes.

❌ Situation 2: Nonspecific chronic dizziness

If symptoms of imbalance or dizziness persist for months without characteristics of acute vestibular dysfunction → use code AB32 (Chronic vestibular syndrome) or specific codes for chronic vestibular disorders

Rationale: The acute and monophasic character is essential for the definition of AB30.

❌ Situation 3: Vertigo of confirmed central origin

If there is already confirmation by neuroimaging of cerebellar stroke, brainstem hemorrhage, or other central structural lesion → use specific code for the neurological lesion (chapter on diseases of the nervous system)

Rationale: Although the presentation may be AVS, coding should reflect the established etiological diagnosis.

❌ Situation 4: Ménière disease in crisis

If a patient with established diagnosis of Ménière disease presents with vertiginous crisis → use specific code for Ménière disease

Rationale: Ménière disease has its own code and should not be classified as AVS.

❌ Situation 5: Intoxication or adverse drug effect

If vertigo is clearly secondary to alcohol intoxication, use of ototoxic drugs, or vestibulotoxic medications → use appropriate codes for intoxication or adverse effects

Rationale: The toxic or drug-related cause should be coded primarily.

Step-by-Step Coding Process

Step 1: Initial Assessment

Confirm the presence of essential elements of acute vestibular syndrome:

1. Acute onset: Symptoms started abruptly, not gradually
2. Continuous vertigo: Rotatory sensation or persistent instability, not episodic
3. Prolonged duration: Expectation of symptoms lasting days to weeks
4. Vestibular signs: Spontaneous nystagmus, gait deviation, postural instability

Practical example: Patient reports waking up with severe vertigo 12 hours ago, unable to stand without support, with three episodes of vomiting. These elements confirm the acute and continuous character necessary for AB30.

Step 2: Verification of Diagnostic Criteria

Perform directed physical examination including:

• Inspection of nystagmus (spontaneous, provoked, positional)
• Head Impulse Test (HIT)
• Assessment of gait and balance
• Skew deviation test (vertical ocular misalignment)
• General neurological examination to exclude central signs

Practical example: On examination, horizontal-rotatory nystagmus beating to the right is identified, HIT positive to the left, ataxic gait with leftward deviation. Absence of cerebellar dysmetria, dysarthria, or other central signs. These findings support peripheral cause and use of AB30.

Step 3: Exclusion of Differential Diagnoses

Systematically evaluate causes that should NOT be coded as AB30:

• BPPV: Dix-Hallpike test negative, continuous symptoms (not episodic)
• Cerebellar stroke: Apply HINTS protocol, consider urgent MRI if risk factors present
• Ménière's disease: Absence of history of previous recurrent episodes with fluctuating hearing loss
• Toxic cause: Negative medication history for recent ototoxic drugs

Practical example: Patient denies previous similar episodes, does not use ototoxic medications, Dix-Hallpike test without vertigo or positional nystagmus. Cranial MRI requested due to advanced age and hypertension, but while awaiting results, AB30 coding is maintained.

Step 4: Determination of Specificity Level

Decide between generic AB30 or subcategories:

• AB30.0 (Vestibular neuritis): When there is evidence of ISOLATED peripheral vestibular dysfunction, without auditory symptoms, usually post-viral
• AB30.1 (Labyrinthitis): When there is simultaneous COCHLEAR AND VESTIBULAR involvement, with associated hearing loss or tinnitus
• AB30 (generic): When the specific etiology has not yet been established or when the cause does not fit into available subcategories

Practical example: Patient with isolated vertigo, without auditory symptoms, preceded by respiratory viral infection, with examination suggestive of right peripheral vestibular dysfunction and normal MRI → specify as AB30.0. If there had also been sudden hearing loss → AB30.1.

Step 5: Documentation and Record

Document in the medical record the following essential elements:

1. Temporal characterization: Date and time of symptom onset
2. Cardinal symptoms: Type of vertigo, associated symptoms (vomiting, instability)
3. Physical examination findings: Detailed description of nystagmus, HIT result, gait
4. Complementary exams: MRI, videonystagmography, audiometry when applicable
5. Differential diagnoses considered: Strokes, BPPV, Ménière's, toxic causes
6. Coding justification: Why AB30 is the appropriate code for this case

Documentation example: "Patient with acute vestibular syndrome (ICD-11: AB30) initiated on 01/15/2026 at 06:00, characterized by continuous rotatory vertigo, vomiting, spontaneous horizontal nystagmus beating to the right, HIT positive to the left. Cranial MRI without signs of stroke. Presumed diagnosis of left vestibular neuritis. Symptomatic therapy initiated and reevaluation scheduled in 48 hours for possible specification as AB30.0."

Complete Practical Example

Clinical Case:

José Silva, 52 years old, banker, controlled hypertension, presents to the emergency department at 2:30 PM reporting that he woke up at 6:00 AM with intense rotatory vertigo. He describes the sensation that "the room is spinning continuously," without periods of relief. He had five episodes of vomiting during the morning and is unable to stand or walk without support due to severe instability. He denies headache, diplopia, dysarthria, weakness, or paresthesias. He reports mild flu-like illness 5 days ago, already resolved. He uses no medications other than losartan for hypertension. He denies head trauma, alcohol or drug use. He has never experienced a similar episode previously.

On physical examination, patient is alert, oriented, but visibly nauseated and uncomfortable. Vital signs: BP 145/90 mmHg, HR 88 bpm, Temp 36.7°C. Bilateral otoscopy normal. He presents with spontaneous horizontal nystagmus beating to the right, which increases on rightward gaze and decreases on leftward gaze (compatible with Alexander's law). Head impulse test (HIT) positive on the left, with evident refixation saccade. Skew deviation test negative. Romberg test impossible to perform due to instability. Ataxic gait with leftward deviation. Muscle strength and sensation preserved in all four limbs. Symmetric and normal tendon reflexes. Preserved appendicular coordination (finger-to-nose and heel-to-knee without dysmetria). No dysarthria or dysphagia.

Step-by-Step Coding:

1. Initial analysis: Patient presents with acute onset (woke up with symptoms), continuous vertigo (not episodic), prolonged duration (8 hours until evaluation with expectation of persistence for days), classic vestibular symptoms (nausea, vomiting, nystagmus, instability). All criteria for acute vestibular syndrome are present.

2. Criteria evaluated:

   • Unidirectional spontaneous nystagmus: present
   • Abnormal HIT: positive (suggests peripheral vestibular dysfunction on the left)
   • Absence of central signs: confirmed (no appendicular ataxia, dysarthria, or other brainstem/cerebellar signs)
   • Instability and gait ataxia: present (compatible with acute vestibular dysfunction)

3. Code selected: AB30 (Acute vestibular syndrome)

4. Justification: Classic presentation of acute vestibular syndrome of probable peripheral origin (vestibular neuritis). Although the examination is highly suggestive of left vestibular neuritis, the generic AB30 is initially chosen pending confirmation with complementary tests (brain MRI to definitively exclude stroke, considering age and hypertension) and possible videonystagmography. After diagnostic confirmation and exclusion of central causes, it may be specified as AB30.0.

5. Documentation: "52-year-old male patient with acute vestibular syndrome (ICD-11: AB30) with onset 8 hours ago. Presents with continuous rotatory vertigo, recurrent vomiting, spontaneous horizontal nystagmus beating to the right with peripheral pattern, HIT positive on the left. Neurological examination without central signs. Cardiovascular risk factors (hypertension) warrant urgent brain MRI to exclude cerebellar/brainstem stroke. Presumptive diagnosis: left vestibular neuritis. Management: ondansetron 8mg IV, dimenhydrinate 50mg IV, intravenous hydration, brain MRI requested urgently (within next 6 hours), observation admission for 24 hours. Reevaluation after MRI results for possible code specification as AB30.0 and vestibular rehabilitation planning."

Related Codes

AB30.0: Vestibular neuritis

Use when there is confirmation of isolated peripheral vestibular dysfunction without auditory symptoms, usually preceded by viral infection. It is characterized by acute vertigo, spontaneous nystagmus, positive HIT contralateral to nystagmus, without hearing loss.

Differentiation: AB30 is used initially when the etiology is still unclear; AB30.0 is used after specific confirmation of vestibular neuritis.

AB30.1: Labyrinthitis

Use when there is simultaneous impairment of cochlear and vestibular functions, with presence of sudden hearing loss or tinnitus in addition to vertigo. It may be of viral, bacterial, or autoimmune origin.

Differentiation: AB30.1 differs from AB30.0 by the presence of associated auditory symptoms.

AB31: Episodic vestibular syndrome

Conditions characterized by recurrent episodes of short-duration vertigo (seconds to hours), including BPPV, vestibular migraine, and Ménière disease.

Differentiation criterion: AB31 is episodic and recurrent; AB30 is continuous and usually monophasic.

AB32: Chronic vestibular syndrome

Vestibular symptoms persisting for months, with partial adaptation and less intense symptoms than in the acute phase.

Differentiation criterion: Duration (AB30: days to weeks; AB32: months to years) and intensity (AB30: severe and disabling symptoms; AB32: milder and adaptive symptoms).

8B93: Ischemic stroke

When neuroimaging confirms stroke involving the cerebellum, brainstem, or central vestibular structures.

Differentiation criterion: AB30 is used in the initial syndromic presentation; after stroke confirmation by imaging, change to the specific stroke code with location.

Differences with ICD-10

| Aspect | ICD-10 | ICD-11 (AB30) | Change | |---------|--------|---------|---------| | Code | H81.2 (Vestibular neuritis), H83.0 (Labyrinthitis) | AB30 (syndrome) + AB30.0 and AB30.1 (etiologies) | Syndromic approach | | Nomenclature | Specific etiological diagnoses | Acute vestibular syndrome as comprehensive category | Better reflects initial diagnostic uncertainty | | Criteria | Based on presumed etiology | Based on temporal clinical presentation | More practical for emergency use | | Specificity | Separate codes for each cause | Syndromic code with subcategories | Allows early coding and later refinement |

ICD-10 required etiological definition from the outset, which often led to inaccurate or premature coding. ICD-11, with AB30, allows coding of the acute clinical syndrome immediately and refining to subcategories (AB30.0 or AB30.1) after further investigation. This is especially useful in urgent/emergency contexts where etiological differentiation is not immediately possible.

Another important change is the explicit recognition that AVS can have multiple etiologies, including central causes (strokes) and peripheral causes (neuritis, labyrinthitis), allowing better epidemiological tracking of the complete spectrum of this clinical presentation.

Frequently Asked Questions

Q: What is the difference between acute vestibular syndrome and benign paroxysmal positional vertigo (BPPV)?

A: The fundamental difference lies in the duration and temporal pattern of symptoms. Acute vestibular syndrome (AB30) is characterized by CONTINUOUS vertigo that persists for days to weeks, present even with the head immobile, accompanied by spontaneous nystagmus. BPPV (AB31.0), on the other hand, manifests as BRIEF episodes of vertigo (lasting seconds to minutes), specifically triggered by changes in head position, with no symptoms between episodes. In BPPV, the Dix-Hallpike test is positive, provoking characteristic vertigo and nystagmus; in AVS, vertigo and nystagmus are present regardless of positioning. Furthermore, patients with AVS typically present with more intense nausea and vomiting and much greater functional impairment than those with BPPV.

Q: Can this code be used in children?

A: Yes, AB30 can be used in children, although acute vestibular syndrome is less common in this age group. In children, the most frequent causes include post-viral labyrinthitis, mild head trauma, and rarely, vestibular migraine or demyelinating causes. Pediatric evaluation requires special attention because young children may have difficulty verbalizing vertigo, manifesting instead with refusal to walk, sudden ataxia, or only irritability and vomiting. Nystagmus examination can be challenging and cooperation for tests such as HIT may be limited. Central causes (strokes, posterior fossa tumors) should be considered with greater caution in children, especially if there are additional neurological signs or severe headache.

Q: How to differentiate peripheral from central cause in acute vestibular syndrome?

A: Differentiation is crucial due to therapeutic and prognostic implications. Use the HINTS protocol (Head Impulse, Nystagmus, Test of Skew): (1) HIT: abnormal in peripheral cause (refixation saccade present), normal in central; (2) Nystagmus: unidirectional that changes direction with gaze suggests peripheral cause, bidirectional or pure vertical nystagmus suggests central cause; (3) Skew deviation: absent in peripheral, present in central. Findings that ALWAYS suggest central cause include: severe appendicular ataxia, dysarthria, dysphagia, diplopia, sensory or motor deficit in extremities, Horner syndrome. The presence of auditory symptoms (hearing loss, tinnitus) suggests peripheral cause. Cardiovascular risk factors (age >50 years, hypertension, diabetes, atrial fibrillation) increase the probability of stroke. When there is doubt or risk factors, brain MRI with diffusion is mandatory to exclude cerebellar or brainstem stroke.

Q: When is brain magnetic resonance imaging necessary?

A: MRI is indicated in: (1) Age >50 years with cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, atrial fibrillation); (2) Any sign or symptom suggestive of central cause (new severe headache, appendicular ataxia, diplopia, dysarthria, motor or sensory deficits); (3) Nystagmus with central characteristics (pure vertical, bidirectional, or that does not suppress with visual fixation); (4) Normal HIT in patient with intense continuous vertigo; (5) Skew deviation present; (6) Clinical deterioration in the first 24-48 hours; (7) Severe symptoms disproportionate to examination findings. MRI with diffusion sequences is superior to CT for detecting acute posterior fossa strokes, especially in the first 24 hours. In young patients without risk factors and with classic presentation of peripheral cause (abnormal HIT, unidirectional nystagmus, no central signs), MRI may not be necessary immediately, but should be considered if there is no improvement after 48-72 hours of evolution.

Q: What is the treatment of acute vestibular syndrome and how does this affect coding?

A: Treatment does not alter AB30 coding, but should be documented. In the acute phase (first 24-72 hours), vestibular suppressants (dimenhydrinate, meclizine) and antiemetics (ondansetron, metoclopramide) are used for symptomatic control. Intravenous hydration may be necessary if vomiting prevents oral intake. IMPORTANT: vestibular suppressants should be discontinued after 2-3 days, as they delay vestibular compensation. Corticosteroids (prednisone 1mg/kg or methylprednisolone) initiated within the first 72 hours may accelerate recovery in vestibular neuritis (AB30.0), although the benefit is controversial. Antivirals (acyclovir, valacyclovir) have not shown consistent benefit and are not routinely recommended. Vestibular rehabilitation should be initiated EARLY (after 48-72 hours) and is the most important component of treatment, significantly accelerating central compensation. Documenting the complete therapeutic plan, including provision for vestibular physiotherapy, is essential to justify coding and ensure continuity of care.

Q: Do patients with acute vestibular syndrome need to be hospitalized?

A: The decision for hospitalization is based on: (1) Severity of symptoms: intractable vomiting preventing oral hydration, extreme instability with fall risk; (2) Need for urgent investigation: cases with suspected central cause requiring urgent MRI and serial neurological evaluation; (3) Associated clinical conditions: elderly patients with multiple comorbidities, patients on anticoagulants, decompensated diabetics; (4) Social conditions: patients living alone or without adequate family support for home care. The majority of uncomplicated peripheral vestibular neuritis cases can be managed on an outpatient basis with follow-up in 24-48 hours, provided there is home support and ability for oral rehydration. Typical hospitalization lasts 24-72 hours for symptomatic control, hydration, examination performance, and initiation of vestibular rehabilitation. Documenting the criteria that justified hospitalization or discharge is important for audit and care quality.

Important Aspects for Professionals

For Physicians

• Always apply HINTS protocol in patients with acute vestibular syndrome, especially if age >50 years or cardiovascular risk factors
• Do not rely exclusively on computed tomography for exclusion of cerebellar stroke; MRI with diffusion is the examination of choice
• Limit vestibular suppressants to 2-3 days to avoid delaying central vestibular compensation
• Refer early to vestibular physiotherapy (after 48-72h), the main factor for functional recovery
• Document in detail findings of vestibular physical examination (type of nystagmus, HIT result, gait) to justify coding

For Coders

• AB30 is appropriate in initial evaluation, before definitive etiological confirmation
• Await MRI results and specialized evaluations before specifying as AB30.0 or AB30.1
• If patient has confirmed diagnosis of vestibular neuritis at follow-up visit, update from AB30 to AB30.0
• Do not use AB30 in cases already diagnosed with BPPV (use AB31.0) or Ménière disease
• Always verify if there is documentation of exclusion of central causes before coding as AB30

For Managers

• Patients with AB30 frequently require urgent cranial MRI; ensure facilitated access to neuroimaging
• Observation period of 24-48 hours in hospital setting may prevent readmissions and complications
• Outpatient vestibular rehabilitation programs should be available for all patients with AB30
• Audit cases coded as AB30 to verify adequacy of investigation for central causes (especially strokes)
• Conversion rate from AB30 to AB30.0/AB30.1 is an indicator of diagnostic quality

References

• World Health Organization (WHO). ICD-11 - International Classification of Diseases, 11th Revision. 2024.
• Kerber KA, Newman-Toker DE. Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice. Neurol Clin. 2015;33(3):565-575.
• Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ. 2011;183(9):E571-E592.
• Strupp M, Brandt T. Vestibular neuritis. Semin Neurol. 2009;29(5):509-519.
• Edlow JA, Gurley KL, Newman-Toker DE. A New Diagnostic Approach to the Adult Patient with Acute Dizziness. J Emerg Med. 2018;54(4):469-483.

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Article updated according to ICD-11 version 2024-01 Technical content reviewed by experts in medical coding and neurotology